Included in the formulation
АТХ:M.01.A.B.08 Eto-dolac
Pharmacodynamics:NSAID, an indoleacetic acid derivative, has a tetrahydropyranindole nucleus in the composition. Has anti-inflammatory, analgesic, antipyretic effect.
Oppresses the synthesis of prostaglandins in the focus of inflammation, so the drug reduces the sensitivity of pain receptors to inflammatory mediators, such as histamine, serotonin, kinin.
It inhibits cyclooxygenase and suppresses the synthesis of prostaglandins from arachidonic acid. In addition, the drug has a uricosuric effect.
Pharmacokinetics:After ingestion, the drug is well absorbed from the digestive tract. Maximum concentration is reached in the plasma for about 1 hour and is 18 mg / ml. Bioavailability of the drug is 68 mg / ml / h and is not dependent on food intake or antacids.
Virtually completely binds to plasma proteins; the free fraction is 1.2-4.7%. The volume of distribution is 0.4 l / kg, the plasma clearance is 41 ml / h / kg. Half-life is 7 hours.
Indications:Inflammatory and degenerative diseases of the musculoskeletal system: psoriatic, rheumatoid, gouty arthritis, ankylosing spondylitis (Bechterew's disease), osteoarthritis.
Pain syndrome: myalgia, ossalgia, arthralgia, headache and toothache, posttraumatic pain syndrome, accompanied by inflammation, algodismenorea.
It is intended for symptomatic therapy, reducing pain and inflammation at the time of use, the progression of the disease is not affected.
XIII.M05-M14.M05 Seropositive rheumatoid arthritis
XIII.M45-M49.M45 Ankylosing spondylitis
XVIII.R50-R69.R52.2 Another constant pain
XIII.M70-M79.M79.0 Rheumatism, unspecified
XIII.M15-M19 Osteoarthritis
Contraindications:Peptic ulcer of the stomach and duodenum; history of bronchial asthma, rhinitis, urticaria, developed after taking acetylsalicylic acid or other NSAIDs; pregnancy; lactation (breastfeeding); hypersensitivity to etodolac.
Etopolac should not be used in children younger than 15 years of age.
Carefully:In patients with heart failure, cirrhosis, chronic renal or hepatic insufficiency, during treatment with diuretics, as well as in elderly patients, control of liver and kidney function at the beginning of treatment is necessary.
Pregnancy and lactation:Action category for the fetus by FDA-C. Not to accept.
At the time of treatment, breastfeeding should be discontinued (it is not known whether the etodolac in breast milk).
Dosing and Administration:Take inside at a daily dose of 400-1200 mg, the frequency of reception - 2 times a day (morning and evening). The maximum daily dose is 1200 mg.
For patients with a body weight of 60 kg or less, the maximum daily dose is 20 mg / kg.
Side effects:From the side digestive system: nausea, epigastric pain, diarrhea, flatulence, constipation, transient increase in hepatic transaminase activity.
Allergic reactions: skin rash, itching.
From the side respiratory system: bronchospasm (in patients with the "aspirin triad").
From the side CNS: dizziness, headache, fatigue.
Overdose:Symptoms: nausea, vomiting, epigastric pain, arterial hypertension, anaphylactic reactions.
Treatment: symptomatic.
Interaction:It is highly associated with blood plasma proteins, when used simultaneously with other drugs that also bind to plasma proteins (eg, anticoagulants), it is possible to enhance the effects of both active substances (dose adjustment is required).
E-dolac enhances the effects of oral anticoagulants (fenindion) and heparin.
Etodolac enhances the antiaggregant properties of ticlopidine (when they are used simultaneously, monitoring the duration of bleeding).
Etopolac may enhance the hypoglycemic effect of sulfonamides.
Etopolac increases the concentration of lithium in blood plasma (with simultaneous use it is necessary to control the concentration of lithium in the blood).
It increases the hematologic toxicity of methotrexate.
With simultaneous application etodolac weakens the action of diuretics.
When combined with other NSAIDs, the risk of peptic ulcer and gastrointestinal bleeding increases.
Special instructions:Etopolac can inhibit platelet function, especially in patients taking anticoagulants; in such cases, regular clinical monitoring is required. The treatment is stopped if bleeding develops.
In patients with heart failure, cirrhosis, chronic renal or hepatic insufficiency, during treatment with diuretics, as well as in elderly patients, control of liver and kidney function at the beginning of treatment is necessary.
When determining the level of bilirubin using the Ehrlich reagent against the background of taking etodolac, a false positive result (the presence of phenolic metabolites of etodolac in the urine) may occur.